Sleepwalking: Causes and Treatments

What actually is sleepwalking – and how can it be treated? We explain why sleepwalking is possible and what can be done about it.

What is sleepwalking?

Sleepwalking (“somnambulism”, also: nightwalking) means that affected persons suddenly get up in deep sleep, leave the bed and walk around at night. Sometimes they even say sentences or carry out concrete actions. Sleepwalkers are usually not responsive – only the parts of their brain responsible for controlling movement are actually active during sleepwalking.

Sleepwalkers usually just walk straight ahead – even if the path ahead of them is actually over and they might crash, for example. It is therefore important to guide the person sleepwalking carefully out of a potentially dangerous environment and back to bed. Often the nightly “walks” only last a few minutes, and the sleepwalker cannot remember the incident the next day.

Sleepwalking from moonstruck?

By the way, in former times sleepwalking was also called “moonwalking”. People believed that the phenomenon was triggered by certain light sources, such as the full moon – hence the name. This assumption has since been scientifically disproved.

What is the reason for sleepwalking?

It is currently assumed that sleepwalking is caused by a disturbance of the wake-up mechanism in the brain. In fact, all people wake up briefly more often at night – but they don’t notice anything. Normally, you just move a little or turn to the other side, then you go back to sleep. With a sleepwalker, on the other hand, this short wake-up time causes him to get up and perform unconscious actions.

Sleepwalking is one of the sleep disorders

From a medical point of view, sleepwalking belongs to the sleep disorders, more precisely to the so-called parasomnias. These are unwanted behavioural problems that occur mainly during sleep. Nightmares and nocturnal leg cramps are also included.

How can I tell if someone is sleepwalking?

For example, at first it can be difficult for your partner to tell if someone is sleepwalking – especially if you are still drowsy. Often it is already an indication if you speak directly to the person concerned in bed and get no reaction. Although sleepwalkers sometimes even give answers, these are then unclear and difficult to understand. These symptoms also point to sleepwalking:

• Expressionless, stiff face
• The eyes are open, but seem to stare into nothingness
• Sometimes an action is carried out again and again, for example opening and closing a cabinet door
• Clumsiness and lack of coordination
• In rare cases aggressive behaviour

In rare cases, sleepwalkers can even perform complex actions like driving a car. In addition, the case of a Canadian has led to a debate to this day about whether sleepwalking can become violent or even kill someone: In 1987, Kenneth Parks suddenly got up in the middle of the night, drove 23 kilometers to his parents-in-law and killed his mother-in-law with a knife. When he woke up, he could not remember the incident.

An examination in a sleep laboratory confirmed that Parks had performed the act in his sleep – he was acquitted. Such consequences are possible with the so-called REM sleep behavioral disorder, which, unlike sleepwalking, does not occur in deep sleep but during the dream phase. The REM-sleep behavioral disorder also belongs to the parasomnias.

Who is affected by sleepwalking?

Children are significantly more frequent sleepwalkers than adults: Experts assume that about ten to 30 percent of all children between five and twelve are at least temporarily sleepwalkers. In about 70 to 80 percent of cases, the phenomenon disappears of its own accord with the onset of puberty. The reason for this has not yet been fully researched, but it is assumed that the development of the central nervous system plays a role in this process. It is estimated that only one to two percent of adults suffer from chronic sleepwalking. There might be different causes for this, for example different diseases.

What are the causes and risk factors for sleepwalking?

So far, the causes of sleepwalking have not been fully clarified, but there are several possible triggers and risk factors that may play a role. These include:

• Genetic factors (children of sleepwalkers are ten times more likely to be affected themselves than children of parents who do not sleepwalk)
• Shift work
• Certain drugs
• Stress / mental strain
• Alcohol and/or drug abuse
• Various illnesses, for example fever, depression, sleep disorders, neurological disorders such as epileptic seizures or the restless legs syndrome, in which one has a constant urge to move one’s legs, which often also hurt

Treatment: What can you do against sleepwalking?

As already mentioned, sleepwalking in children usually resolves itself sooner or later. If, on the other hand, it persists or occurs for the first time in adults, the first thing to do is to find out the possible causes of the night-time disturbances and treat them. More often than not, unprocessed psychological stress or problems with self-esteem are behind the sleepwalking, which can be worked out and treated in psychotherapy. If there is an underlying disease that triggers the sleepwalking problem, it must be treated.

Drugs are only used in particularly severe cases when other measures do not bring any improvement and sleepwalking poses a serious risk to life and limb of the person affected.

Safety measures for the health during sleepwalking

If it is known that someone is a sleepwalker, certain safety precautions should be taken so that the person concerned cannot unconsciously walk through the house or even leave it. The most important thing is to lock doors and windows at night and to hide the front door key well. If the sleepwalker knows the hiding place, he could unconsciously visit it and still leave the house.

How can sleepwalking be prevented?

If you know that you have a tendency to sleepwalk, you can at least reduce the risk of a nocturnal outing with a few measures. The following tips can help:

• Generally enough sleep
• Relaxation techniques, for example autogenic training or progressive muscle relaxation
• Reduce stress
• Minimising pre-sleeping stimuli – this includes, for example, banning electronic devices that emit blue-wave light (mobile phones, laptops, etc.) from the bedroom
• Create a generally pleasant sleeping environment, e.g. by maintaining an optimal temperature (most people sleep best at 18 degrees), comfortable sleeping clothes etc.

Especially lack of sleep and stress are strong triggers for people susceptible to sleepwalking.